Journal article
Duration of antimicrobial treatment for complicated intra-abdominal infections after definitive source control: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma
The journal of trauma and acute care surgery, v 95(4), pp 603-612
01 Oct 2023
PMID: 37316989
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: Recent studies have evaluated outcomes associated with duration of antimicrobial treatment for complicated intra-abdominal infections (cIAI). The goal of this guideline was to help clinicians better define appropriate antimicrobial duration in patients who have undergone definitive source control for cIAI.
METHODS: Aworking group of Eastern Association for the Surgery of Trauma (EAST) performed a systematic review and meta-analyses of the available data pertaining to the duration of antibiotics after definitive source control of cIAI in adult patients. Only studies that compared patients treated with short vs. long duration antibiotic regimens were included. The critical outcomes of interest were selected by the group. Noninferiority of short compared with long duration of antimicrobial treatment was defined as an indicator for a potential recommendation in favor of shorter antibiotics course. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the quality of the evidence and to formulate recommendations.
RESULTS: Sixteen studieswere included. The short duration ranged from1 dose to =10 days, with an average of 4 days, and the long duration ranged > 1 day to 28 days, with an average of 8 days. There were no differences between short and long duration of antibiotics in terms of mortality (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.56-1.44), rate of surgical site infection (OR, 0.88; 95% CI, 0.56-1.38); persistent/recurrent abscess (OR, 0.76; 95% CI, 0.45-1.29); unplanned interventions (OR, 0.53; 95% CI, 0.12-2.26); hospital length of stay (mean difference, -2.62 days; CI, -7.08 to 1.83 days); or readmissions (OR, 0.92; 95% CI, 0.50-1.69). The level of evidence was assessed as very low.
CONCLUSION: The groupmade a recommendation for shorter (four or less days) versus longer duration (eight ormore days) of antimicrobial treatment in adult patients with cIAIs who had definitive source control. (J Trauma Acute Care Surg. 2023;95: 603-612. Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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Details
- Title
- Duration of antimicrobial treatment for complicated intra-abdominal infections after definitive source control: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma
- Creators
- Jin H. Ra - Univ N Carolina, Dept Surg, Chapel Hill, NC USARishi Rattan - Case Western Reserve UniversityNimitt J. Patel - Case Western Reserve UniversityBishwajit Bhattacharya - Case Western Reserve UniversityChristopher A. Butts - University of Maryland, BaltimoreShailvi Gupta - Case Western Reserve UniversitySofya H. Asfaw - University of Maryland, BaltimoreJohn J. Como - Case Western Reserve UniversitySheryl M. Sahr - Case Western Reserve UniversityNikolay Bugaev - Case Western Reserve University
- Publication Details
- The journal of trauma and acute care surgery, v 95(4), pp 603-612
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 10
- Grant note
- The authors declare no funding or conflicts of interest.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:001071080700027
- Scopus ID
- 2-s2.0-85172033902
- Other Identifier
- 991021929612404721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Critical Care Medicine
- Surgery